Perinatal inflammation is associated with social and motor impairments in preterm children without severe neonatal brain injury

https://doi.org/10.1016/j.ejpn.2020.06.008Get rights and content
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Highlights

  • Preterm children without severe neonatal brain injury were evaluated at 30 months.

  • Perinatal inflammation was not associated with lower global development.

  • Perinatal inflammation was associated with poorer social and motor abilities.

Abstract

Objective

To test the association between exposure to perinatal inflammation – i.e. clinical chorioamnionitis or early-onset neonatal infection – in preterm children without severe neonatal brain injury and neurodevelopmental outcome at 30 months of corrected age (CA).

Design

Cross-sectional study from a French regional cohort of clinical follow-up (SEVE Network).

Patients

One hundred sixty-four surviving neonates without severe brain injury – namely, grade III and IV cerebral hemorrhage and cystic periventricular leukomalacia – and without late-onset neonatal inflammation exposure – namely, late-onset neonatal infection and necrotizing enterocolitis –, born at less than 33 weeks of gestational age from November 2011 to June 2015 and enrolled in the SEVE Network.

Main outcome measure

Global developmental quotient (DQ) score of the revised Brunet-Lézine scale and its four indices measured by the same neuropsychologist at 30 months of CA.

Results

After multivariate analysis, exposure to perinatal inflammation was not found significantly associated with a modification of the global DQ score (coefficient -1.7, 95% CI -4.8 to 1.3; p = 0.26). Exposure to perinatal inflammation was associated with a decrease of the gross motor function DQ score (coefficient -6.0, 95% CI -9.9 to -2.1; p < 0.01) and a decrease of the sociability DQ score (coefficient -5.1, 95% CI -9.2 to -0.9; p = 0.02). Language and visuospatial coordination DQ scores were not affected by exposure to perinatal inflammation.

Conclusion

Exposure to perinatal inflammation in preterm children without severe neonatal brain injury is independently associated with decreased motor and social abilities at 30 months of CA.

Keywords

Prematurity
Chorioamnionitis
Early-onset neonatal infection
Development
Revised Brunet-Lézine scale

Abbreviations

β
linear coefficient.
CA
corrected age.
CI
confidence intervals.
CP
cerebral palsy.
DQ
developmental quotient.
GA
gestational age.
IVH
intraventricular hemorrhage.
MRI
magnetic resonance imaging.
RBL
revised Brunet-Lézine scale

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